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10 Disorders of Sleep and Wakefulness and Their Treatment: Neurotransmitter Networks for Histamine and Orexin Disorders of Sleep and Wakefulness and Their Treatment: Neurotransmitter Networks for Histamine and Orexin Neurobiology of Sleep and Wakefulness  402 ...

11 Attention Deficit Hyperactivity Disorder and Its Treatment Attention Deficit Hyperactivity Disorder and Its Treatment Symptoms and Circuits: ADHD as a Disorder of the Prefrontal Cortex  449 ADHD as a Disorder of Inefficient “Tuning” of the Prefrontal Cortex...

12 Dementia: Causes, Symptomatic Treatments, and the Neurotransmitter Network Acetylcholine reader with ideas about the clinical and biological aspects of dementia and its current management with various approved drugs as well as novel agents on the horizon. A...

13 Impulsivity, Compulsivity, and Addiction 1 Impulsivity, Compulsivity, and Addiction What Are Impulsivity and Compulsivity?  538 Neurocircuitry and the Impulsive–Compulsive Disorders  539 The Dopamine Theory of Addiction: The Mesolimbic Dopamine Circuit as t...

ANTIPSYCHOTIC DRUGS

General introduction

Classification of antipsychotics The Maudsley® Prescribing Guidelines in Psychiatry, Fifteenth Edition. David M. Taylor, Thomas R. E. Barnes and Allan H. Young. © 2025 David M. Taylor. Published 2025 by John Wiley & Sons Ltd. Chapter 1 ANTIPSYCHOTIC DRUGS Gene...

Choosing an antipsychotic 2 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 very low or zero liability for extrapyramidal symptoms (EPS). Others show dose-­related effects, although, unlike with typical drugs, therapeutic activity can usually be a...

Relative efficacy Schizophrenia and related psychoses CHAPTER 1 Antipsychotics are effective in both the acute and maintenance treatment of schizophrenia and other psychotic disorders. They differ in their pharmacology, pharmacokinetics, overall efficacy/effec...

References Schizophrenia and related psychoses CHAPTER 1 References Zohar J, et al. Neuroscience-­based Nomenclature (NbN): a call for action. World J Biol Psychiatry 2016; 17:318–320. National Institute for Health and Care Excellence. Medicines adherence: in...

General principles of prescribing Schizophrenia and related psychoses CHAPTER 1 General principles of prescribing ■ ■The lowest possible dose should be used. For each patient, the dose should be titrated to the lowest known to be effective (see section on mini...

Antipsychotics – minimum effective doses 8 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 Antipsychotics – minimum effective doses Table 1.1 suggests the minimum dose of individual antipsychotics likely to be effective in first-­ or multi-­episod...

References Schizophrenia and related psychoses CHAPTER 1 References Dudley K, et al. Chlorpromazine dose for people with schizophrenia. Cochrane Database Syst Rev 2017; 4(4):CD007778. McGorry PD. Recommended haloperidol and risperidone doses in first-­episode...

Quick reference for licensed maximum doses Schizophrenia and related psychoses CHAPTER 1 Quick reference for licensed maximum doses Table 1.2 lists the licensed maximum doses of antipsychotics according to the European Medicines Agency, as of January 2025.1 Ta...

Clinical effectiveness

Adverse effects

Summary 106 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 Penfluridol weekly Background Penfluridol is a diphenylbutylpiperidine FGA available in countries such as Brazil, China, India, Israel and the Netherlands and can be imported to other cou...

References Schizophrenia and related psychoses CHAPTER 1 In practice, penfluridol is usually started at a dose of 20mg and increased to a maximum of 40mg after assessment. Steady-state levels are effectively reached after 2–3 weeks. Monitoring includes investi...